Rural or urban living and Parkinson's disease

Ferraz, Henrique B.; Andrade, Luiz A. F.; Tumas, Vítor; Calia, Leandro C.; Borges, Vanderci

doi:10.1590/S0004-282X1996000100006

Abstracts

Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.

Parkinson's disease epidemiology; Parkinson's disease etiology; environmental factors

A etiologia da doença de Parkinson (DP) é ainda desconhecida mas parece que fatores ambientais podem estar envolvidos. A incidência da DP, particularmente a de início precoce, parece ser maior em indivíduos com antecedente de moradia na zona rural. Avaliamos as características clínicas e a progressão da DP em 118 pacientes segundo os antecedentes de área de moradia pregressa. Havia 71 pacientes (60,2%) com antecedente de no mínimo 10 anos na zona rural (especialmente nas fases iniciais da vida), o chamado Grupo Rural (GR), e 47 pacientes (39,8%) que tiveram antecedente de vida exclusivamente urbana, o chamado Grupo Urbano (GU). A média de idade de início dos sintomas foi 58,8 anos no GR e de 54,1 anos no GU. A forma mista da DP (com tremor, bradicinesia e rigidez) foi a mais frequente em ambos os grupos. Um período de acompanhamento de no mínimo 6 meses foi obtido em 63 pacientes (média de 20 meses de acompanhamento) e a progressão da sintomatologia foi semelhante nos dois grupos (GR e GU). Nossos dados indicam que o antecedente de moradia não parece ser determinante para o padrão de manifestação clínica e de evolução da DP.

doença de Parkinson; epidemiologia; doença de Parkinson; etiologia; fatores ambientais

Rural or urban living and Parkinson's disease

Antecedente de vida rural ou de vida urbana e doença de Parkinson

Henrique B. Ferraz^I; Luiz A. F. Andrade^I; Vítor Tumas^II; Leandro C. Calia^I; Vanderci Borges^I

^IMovement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo - Brazil

^IIDepartment of Neurology, Psychiatry and Medical Psychology, Faculdade de Medicina da Universidade de São Paulo -Ribeirão Preto (FMUSP-RP), Ribeirão Preto - Brazil

ABSTRACT

Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.

Key words:Parkinson's disease epidemiology, Parkinson's disease etiology, environmental factors.

RESUMO

A etiologia da doença de Parkinson (DP) é ainda desconhecida mas parece que fatores ambientais podem estar envolvidos. A incidência da DP, particularmente a de início precoce, parece ser maior em indivíduos com antecedente de moradia na zona rural. Avaliamos as características clínicas e a progressão da DP em 118 pacientes segundo os antecedentes de área de moradia pregressa. Havia 71 pacientes (60,2%) com antecedente de no mínimo 10 anos na zona rural (especialmente nas fases iniciais da vida), o chamado Grupo Rural (GR), e 47 pacientes (39,8%) que tiveram antecedente de vida exclusivamente urbana, o chamado Grupo Urbano (GU). A média de idade de início dos sintomas foi 58,8 anos no GR e de 54,1 anos no GU. A forma mista da DP (com tremor, bradicinesia e rigidez) foi a mais frequente em ambos os grupos. Um período de acompanhamento de no mínimo 6 meses foi obtido em 63 pacientes (média de 20 meses de acompanhamento) e a progressão da sintomatologia foi semelhante nos dois grupos (GR e GU). Nossos dados indicam que o antecedente de moradia não parece ser determinante para o padrão de manifestação clínica e de evolução da DP.

Palavras-chave: doença de Parkinson, epidemiologia; doença de Parkinson, etiologia; fatores ambientais.

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Aceite: 17-outubro-1995.

Dr. Henrique B. Ferraz - Al. Casa Branca 799 apto 72 - 01408-001 São Paulo SP - Brasil.

1. Barbeau A, Cloutier T, Roy M, Plasse L, Paris S, Poirier J. Ecogenetics of Parkinson's disease: 4-hydroxylation of debrisoquine. Lancet 1985;2:1213-1216.
2. Barbeau A, Roy M, Bernier G, Campanella G, Paris S. Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas. Can J Neurol Sci 1987; 14:36-41.
3. Burn DJ, Mark MH, Playford ED, Maraganore DM, Zimmerman TR Jr, Duvoisin RC, Harding AE, Marsden CD, Brooks DJ. Parkinson's disease in twins studied with 18F-dopa and positron emission tomography. Neurology 1992;42:1894-1900.
4. Calne DB. Is "Parkinson's disease" one disease? J Neurol Neurosurg Psychiatry 1989;Special Suppl: 18-21.
5. Calne DB, Langston JW. Aetiology of Parkinson's disease. Lancet 1983;2:1457-1459.
6. Duvoisin RC, Yahr MD. Encephalitis and parkinsonism. Arch Neurol 1965;12:227-239.
7. Ferraz HB, Bertolucci PHF, Pereira JS, Lima JGC, Andrade LAF. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication. Neurology 1988;38:550-553.
8. Fleming L, Mann JB, Bean J, Briggle T, Sanchez-Ramos JR. Parkinson's disease and brain levels of organochlorine pesticides. Ann Neurol 1994;36:100-103.
9. Golbe LI. Young-onset Parkinson's disease: a clinical review. Neurology 1991;41:168-173.
10. Granieri E, Carreras M, Casetta I, Govoni V, Tola MR, Paolino E, Monetti VC, De Bastiani P. Parkinson's disease in Ferrara, Italy, 1967 through 1987. Arch Neurol 1991;48:854-857.
11. Herishanu YO, Goldsmith JR, Abarbanel JM, Weinbaum Z. Clustering of Parkinson's disease in southern Israel. Can J Neurol Sci 1989;16:402-405.
12. Roller W, Vetere-Overfield B, Gray C, Alexander C, Chin T, Dolezal J, Hassanein R, Tanner C. Environmental risk factor in Parkinson's disease. Neurology 1990;40:1281-1221.
13. Langston JW, Ballard P, Tetrud JW, Irving I. Chronic parkinsonism in humans due to a product of meperidine-analog synthesis. Science 1983;219:979-980.
14. Lazzarini AM, Myers RH, Zimmerman TR, Mark MH, Golbe LI, Sage JI, Johnson WG, Duvoisin RC. A clinical genetic study of Parkinson's disease: evidence for dominant transmission. Neurology 1994;44:499-506.
15. Rajput AH, Uitti RJ, Stern W, Laverty W. Early onset Parkinson's disease in Saskatchewan: environmental considerations for etiology. Can J Neurol Sci 1986;13:312-316.
16. Semchuk KM, Love EJ, Lee RG. Parkinson's disease and exposure to agricultural work and pesticide chemicals. Neurology 1992;42:1328-1335.
17. Snyder S, D'Amato RJ. MPTP: a neurotoxin relevant to the pathophysiology of Parkinson's disease: the 1985 George C. Cotzias Lecture. Neurology 1986;36:250-258.
18. Tanner CM. Influence of environmental factors on the onset of Parkinson's disease. Neurology 1986;36(Suppl.1):215.
19. Ward CD, Duvoisin RC, Ince SE, Nutt JD, Eldridge R, Calne DB. Parkinson's disease in 65 pairs of twins and in a set of quadruplets. Neurology 1983;33:815-824.

Publication Dates

Publication in this collection
07 Dec 2010
Date of issue
Mar 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Barbeau A, Cloutier T, Roy M, Plasse L, Paris S, Poirier J. Ecogenetics of Parkinson's disease: 4-hydroxylation of debrisoquine. Lancet 1985;2:1213-1216.

[2] 2. Barbeau A, Roy M, Bernier G, Campanella G, Paris S. Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas. Can J Neurol Sci 1987; 14:36-41.

[3] 3. Burn DJ, Mark MH, Playford ED, Maraganore DM, Zimmerman TR Jr, Duvoisin RC, Harding AE, Marsden CD, Brooks DJ. Parkinson's disease in twins studied with 18F-dopa and positron emission tomography. Neurology 1992;42:1894-1900.

[4] 4. Calne DB. Is "Parkinson's disease" one disease? J Neurol Neurosurg Psychiatry 1989;Special Suppl: 18-21.

[5] 5. Calne DB, Langston JW. Aetiology of Parkinson's disease. Lancet 1983;2:1457-1459.

[6] 6. Duvoisin RC, Yahr MD. Encephalitis and parkinsonism. Arch Neurol 1965;12:227-239.

[7] 7. Ferraz HB, Bertolucci PHF, Pereira JS, Lima JGC, Andrade LAF. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication. Neurology 1988;38:550-553.

[8] 8. Fleming L, Mann JB, Bean J, Briggle T, Sanchez-Ramos JR. Parkinson's disease and brain levels of organochlorine pesticides. Ann Neurol 1994;36:100-103.

[9] 9. Golbe LI. Young-onset Parkinson's disease: a clinical review. Neurology 1991;41:168-173.

[10] 10. Granieri E, Carreras M, Casetta I, Govoni V, Tola MR, Paolino E, Monetti VC, De Bastiani P. Parkinson's disease in Ferrara, Italy, 1967 through 1987. Arch Neurol 1991;48:854-857.

[11] 11. Herishanu YO, Goldsmith JR, Abarbanel JM, Weinbaum Z. Clustering of Parkinson's disease in southern Israel. Can J Neurol Sci 1989;16:402-405.

[12] 12. Roller W, Vetere-Overfield B, Gray C, Alexander C, Chin T, Dolezal J, Hassanein R, Tanner C. Environmental risk factor in Parkinson's disease. Neurology 1990;40:1281-1221.

[13] 13. Langston JW, Ballard P, Tetrud JW, Irving I. Chronic parkinsonism in humans due to a product of meperidine-analog synthesis. Science 1983;219:979-980.

[14] 14. Lazzarini AM, Myers RH, Zimmerman TR, Mark MH, Golbe LI, Sage JI, Johnson WG, Duvoisin RC. A clinical genetic study of Parkinson's disease: evidence for dominant transmission. Neurology 1994;44:499-506.

[15] 15. Rajput AH, Uitti RJ, Stern W, Laverty W. Early onset Parkinson's disease in Saskatchewan: environmental considerations for etiology. Can J Neurol Sci 1986;13:312-316.

[16] 16. Semchuk KM, Love EJ, Lee RG. Parkinson's disease and exposure to agricultural work and pesticide chemicals. Neurology 1992;42:1328-1335.

[17] 17. Snyder S, D'Amato RJ. MPTP: a neurotoxin relevant to the pathophysiology of Parkinson's disease: the 1985 George C. Cotzias Lecture. Neurology 1986;36:250-258.

[18] 18. Tanner CM. Influence of environmental factors on the onset of Parkinson's disease. Neurology 1986;36(Suppl.1):215.

[19] 19. Ward CD, Duvoisin RC, Ince SE, Nutt JD, Eldridge R, Calne DB. Parkinson's disease in 65 pairs of twins and in a set of quadruplets. Neurology 1983;33:815-824.